System and Method for Preparing a Pharmaceutical Compound

ABSTRACT

A system for preparing a pharmaceutical compound comprises: a computing device comprising a user interface providing an operator with instructions for preparing the pharmaceutical compound and at least one processor operatively connected to the user interface; a scale operatively connected to the at least one processor; and an image capture device operatively connected to the at least one processor and the scale and positioned to capture an image of at least one of a component used in preparing the pharmaceutical compound and the pharmaceutical compound.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/877,022, filed May 18, 2020, which is a divisional of U.S. patentapplication Ser. No. 14/847,508, filed Sep. 8, 2015 (now U.S. Pat. No.10,692,207), which claims priority to U.S. Provisional Application Ser.No. 62/047,325, filed Sep. 8, 2014, entitled “Automated VisualDocumentation Feature with Minimal User Input”, U.S. ProvisionalApplication Ser. No. 62/072,160, filed Oct. 29, 2014, entitled “EnhancedPharmacist Review Module for a System for Preparing a PharmaceuticalCompound”, U.S. Provisional Application Ser. No. 62/072,054, filed Oct.29, 2014, entitled “Aerodynamically Streamlined Enclosure for InputDevices of a Medication Preparation System”, U.S. ProvisionalApplication Ser. No. 62/078,067, filed Nov. 11, 2014, entitled“Aerodynamically Streamlined Enclosure for Input Devices of a MedicationPreparation System”, and U.S. Provisional Application No. 62/077,968,filed Nov. 11, 2014, entitled “Enhanced Platen for PharmaceuticalCompounding”, the entire disclosures of each of which are herebyincorporated by reference.

BACKGROUND OF THE INVENTION Field of the Invention

The present disclosure is generally directed to systems and methods forpreparing and administering a prescribed fluidic pharmaceuticalcompound, such as a chemotherapy compound and, more specifically, tosystems and methods that allow a physician to enter a prescription for apatient that is subsequently verified for accuracy, prepared based oncomputer-aided instruction, verified based on a measured weight,substantially automatically provided with visual documentation, andadministered to a patient.

Description of Related Art

Many technical functions involving the preparation and distribution ofdrugs may be performed in a pharmacy by a pharmacy technician orlicensed nurse. When a non-pharmacist performs such functions, apharmacist must generally verify their work. Various systems have beendeveloped that take images of the various steps of the preparation of apharmaceutical compound by a non-pharmacist technician to allow apharmacist to later review the preparation. Such systems typicallyrequire the technician to take some type of active step in order tocapture an image of the drug preparation step. For instance, the usermay be required to use a touch screen or foot pedal to trigger imagecapture.

However, since such systems require an active step by the non-pharmacisttechnician to capture the appropriate image, errors may occur thatprevent the supervising pharmacist from properly verifying theprescription. In addition, such prior art systems do not include anyother mechanism for verifying the prescription and rely solely on theimages obtained during the preparation of the prescription forverification.

In addition, systems have also been developed that utilize gravimetricinformation, checked by a methodology, to confirm the proper drugconcentration. However, there is not a current system that combinesinformation from an image verification system and a gravimetricverification system to ensure that a drug has been appropriatelycompounded.

Accordingly, a need exists for a system that triggers an image capturingstep when certain criteria of the drug preparation have been met andmoves to the next step of the drug preparation without any additionaluser input. A further need exists for a system that displays both imageinformation and gravimetric measurements obtained during drugpreparation steps to a reviewing pharmacist in a clear and easilyreadable manner, such that the pharmacist can quickly approve or rejecta particular drug preparation.

SUMMARY OF THE INVENTION

According to one aspect of the invention, provided is a system forpreparing a pharmaceutical compound. The system comprises: a computingdevice comprising a user interface providing an operator withinstructions for preparing the pharmaceutical compound and at least oneprocessor operatively connected to the user interface; a scaleoperatively connected to the at least one processor; and an imagecapture device operatively connected to the at least one processor andthe scale and positioned to capture an image of at least one of acomponent used in preparing the pharmaceutical compound and thepharmaceutical compound. In one embodiment, the scale may be configuredto transmit a signal to the at least one processor indicating that aweight detected thereby has changed when the at least one component isplaced thereon and, based on the signal, the at least one processortriggers the image capture device to capture the image of the at leastone component. Alternatively, the scale may be configured to transmit asignal to the at least one processor to verify that a correct amount ofat least one component used in preparing the pharmaceutical compound hasbeen drawn by the operator based on a weight of the at least onecomponent and the at least one processor triggers the image capturedevice to capture the image of the at least one component when the atleast one processor verifies the correct amount of the at least onecomponent.

The image capture device may be triggered to capture the image of the atleast one component once the weight of the at least one component on thescale has stabilized. The image of the at least one component may bedisplayed on the user interface for review by the operator. A removal ofthe at least one component from the scale may cause the at least oneprocessor to accept the image, associate the image with a data record,and provide instruction on the user interface to allow the operator tomove to a next step of the instructions for preparing the pharmaceuticalcompound. The data record and images may be provided to a pharmacist forverification. If the image is deemed to be unacceptable by the operator,the user interface may be configured to provide the operator with thecapability to recapture the image.

An upper surface of the scale may be provided with a visual indicationto the operator of a center of an image produced by the image capturedevice. The visual indication may be a cross recess formed in the uppersurface of the scale. A scanner may be operatively coupled to the userinterface. The scanner may be configured to scan a barcode provided onthe at least one component and provide the user interface withinformation regarding the at least one component.

According to another aspect of the invention, provided is a system forpreparing a pharmaceutical compound. The system comprises: a computingdevice comprising a user interface providing an operator withinstructions for preparing the pharmaceutical compound and at least oneprocessor operatively connected to the user interface; a scaleoperatively connected to the at least one processor; and an enclosurecomprising an image capture device having a field of view positioned tocapture an image of an object positioned on the scale during thepreparation of the pharmaceutical compound. The image capture device isoperatively connected to the at least one processor. The scale transmitsa signal to the at least one processor to verify a correct amount of atleast one component of the pharmaceutical compound based on a weight ofthe at least one component. The image capture device captures an imageof the object positioned on the scale when the at least one processorverifies the correct amount of the at least one component.

The enclosure may be positioned above the scale, and may furthercomprise a barcode scanner. The barcode scanner may be angled withrespect to the scale. The barcode scanner may include a sensor that isoffset with respect to the scale. The enclosure may have a streamlinedshape to minimize flow disturbance within a flow hood.

Another object of the system of the present disclosure is to allow apharmacist to accurately review the steps taken by a technicianpreparing a prescribed fluidic pharmaceutical compound in which thesystem displays both image information and gravimetric measurementsobtained during drug preparation steps to the pharmacist in a clear andeasily readable manner, such that the pharmacist can quickly approve orreject a particular drug preparation. Overlaying two differentinformation types (i.e., image and gravimetric information) gives thepharmacist valuable insights regarding the compounding procedure and theopportunity to better judge quality of preparations and techniciansperforming the preparations.

Such a system guides a pharmacist or technician through the differentcompounding steps to prepare a medication order in a pharmacy by givingstep-by-step instructions on a computer screen and verifying thedifferent compounding steps by measuring the weight of the compoundedliquids with a scale. The measured weight is then analyzed with amathematical methodology which checks if the necessary compoundingaccuracy has been accomplished. Every time an item is placed on thescale, a picture of the top of the scale is captured to create a visualdocumentation trail of the compounding process. The pictures are storedtogether with the recorded measurements from the scale and themethodology result in a log file. If a measured weight of a drug is notin the predefined tolerance range of the expected weight, the softwaregenerates instructions to change the amount of the drug to bring itwithin the acceptable tolerance range. The software will not proceed tothe next compounding step as long as the required tolerance of thepresent step has not been accomplished.

In particular, the system includes a pharmacist review module where thepharmacist can review pictures of a particular drug preparation andeither approve or disapprove the preparation for the release to thepatient. The captured images are shown with the correspondingcompounding instructions and an indication of whether the concentrationof a drug is inside or outside of the acceptable tolerance range asdetermined by the mathematical methodology. Accordingly, the pharmacistreview module provides visual information (i.e., the pictures of eachstep of the preparation) overlaid with quantitative measurementscollected with the scale and verified by the mathematical methodology toadhere to predefined acceptance criteria.

More particularly, provided is a system for reviewing a verifyingpreparation of a pharmaceutical compound. The system comprises: aprocessor configured to receive information regarding the preparation ofthe pharmaceutical compound. The information comprises at least oneimage of at least one step of the preparation of the pharmaceuticalcompound and gravimetric measurement information provided by a scaleduring at least one step of the preparation of the pharmaceuticalcompound. The system also includes a user interface operativelyconnected to the processor and configured to display, based oninstructions from the processor, the at least one image of the at leastone step of the preparation of the pharmaceutical compound and anindication of whether a concentration of the pharmaceutical compound iswithin an acceptable tolerance range based on the gravimetricmeasurement information.

The at least one image of the at least one step of the preparation ofthe pharmaceutical compound may include an image of each step of thepreparation of the pharmaceutical compound, and that the user interfaceincludes an area that displays thumbnail images of each step. Agraphical indication may be overlaid onto each of the thumbnail imagesto identify whether the concentration of the pharmaceutical compound iswithin the acceptable tolerance range for the step of the preparation ofthe pharmaceutical compound illustrated in each of the thumbnail images.The user interface may also include an area that displays theinstructions for the preparation of the pharmaceutical compound thatcorrespond to the at least one image of the at least one step of thepreparation of the pharmaceutical compound that is displayed.

These and other features and characteristics of the present invention,as well as the methods of operation and functions of the relatedelements of structures and the combination of parts and economies ofmanufacture, will become more apparent upon consideration of thefollowing description and the appended claims with reference to theaccompanying drawings, all of which form a part of this specification,wherein like reference numerals designate corresponding parts in thevarious figures. It is to be expressly understood, however, that thedrawings are for the purpose of illustration and description only andare not intended as a definition of the limits of the invention. As usedin the specification and the claims, the singular form of “a”, “an”, and“the” include plural referents unless the context clearly dictatesotherwise.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a flow chart of sequential computer-implemented modules forpreparing and administering a prescribed fluidic pharmaceutical compoundin accordance with the present disclosure;

FIG. 2 is a perspective view of a scale and enclosure housing in a flowhood in accordance with an embodiment of the present disclosure;

FIG. 3 is a perspective view of the scale and enclosure housing of FIG.2 in accordance with an embodiment of the present disclosure;

FIG. 4 is a flow chart describing the manner in which a pharmaceuticalcompound is prepared in accordance with an embodiment of the presentdisclosure;

FIGS. 5A-5D, 6A-6D, 7A-7B, 8A-8D, 9A-9D, 10A-10C, 11A-11D, 12A-12C, and13A-13C are exemplary screen shots provided at a user interface of thesystem of FIG. 3 provided during the preparation of a pharmaceuticalcompound;

FIG. 14A is a flow chart describing the manner in which a pharmaceuticalcompound is prepared in accordance with another embodiment of thepresent disclosure;

FIG. 14B is a flow chart describing the manner in which a pharmaceuticalcompound is prepared, which continues from FIG. 14A, in accordance withan embodiment of the present disclosure;

FIG. 15 is a schematic diagram of a pharmacy final verification modulein accordance with an embodiment of the present disclosure;

FIG. 16 is an exemplary screen shot provided at the pharmacy finalverification module allowing a pharmacist to review the preparation ofthe pharmaceutical compound in accordance with the present disclosure;and

FIG. 17 is another exemplary screen shot provided at the pharmacy finalverification module in accordance with the present disclosure.

DESCRIPTION OF THE INVENTION

For purposes of the description hereinafter, the terms “upper”, “lower”,“right”, “left”, “vertical”, “horizontal”, “top”, “bottom”, “lateral”,“longitudinal”, and derivatives thereof, shall relate to the inventionas it is oriented in the drawing figures. However, it is to beunderstood that the invention may assume various alternative variations,except where expressly specified to the contrary. It is also to beunderstood that the specific devices illustrated in the attacheddrawings, and described in the following specification, are simplyexemplary embodiments of the invention. Hence, specific dimensions andother physical characteristics related to the embodiments disclosedherein are not to be considered as limiting.

With reference to FIG. 1 , the system of the present disclosure employsseveral sequential computer-implemented modules for preparing andadministering a prescribed fluidic pharmaceutical compound, such as achemotherapy compound. The modules each include code allowing for inputfrom a user, generating output, and calculating and determininginstructions for the preparation and administration of thepharmaceutical compound that may be implemented on one or moreprocessor(s) 101 of one or more suitable computing device(s). Morespecifically, the system allows a physician to enter a prescription fora patient that is subsequently verified for accuracy, prepared based oncomputer-aided instruction, verified based on a measured weight, andadministered to a patient. Such a system includes specific modulesdescribed in detail below. The modules include: (A) a computerizedphysician ordering entry (CPOE) module 100; (B) a pharmacistverification module 200; (C) a pharmacy preparation module 300; (D) apharmacy final verification module 400; and (E) a bedside (e.g.,administration) module 500. These modules may each be implemented on asingle processor or multiple processors provided on a single computingdevice or may each be implemented on an independent computing devicehaving its own processor where data and information is communicatedbetween the computing devices using any suitable wired or wirelesscommunication protocol, such as, but not limited to Ethernet, WiFi,cellular, Bluetooth, or the like.

A. CPOE Module

The CPOE module 100 enables physicians to input prescribed treatmentorders for patients that include prescribed pharmaceuticals associatedwith particular patients. In particular, the physician entersprescription information for a patient into a computer, and the data istransmitted over an intra-hospital network and stored for retrieval anduse by the subsequent modules described herein. The prescriptioninformation can include one or more pharmaceuticals and thecorresponding dosage/quantities for those pharmaceuticals. The CPOEmodule 100 is an optional component and may not be utilized in everyinstance in which the overall system is implemented.

B. Pharmacist Verification Module

The pharmacist verification module 200 of the system enables pharmaciststo view the prescription information data input by the physician in theCPOE module 100 or from some other source in circumstances when the CPOEmodule 100 is not utilized, and manually verify the prescribed treatmentfor a particular patient. As discussed above, the pharmacistverification module 200 may be implemented on the same computing deviceas the CPOE module 100. Alternatively, the pharmacist verificationmodule 200 may be implemented on a computing device that is remote fromthe computing device that implements the CPOE module 100.

C. Pharmacy Preparation Module

With reference to FIGS. 2 and 3 , the pharmacy preparation module 300includes software and associated hardware, such as pharmacy preparationsystem 1, to guide a pharmacist or non-pharmacist technician through thesteps of preparing a prescribed fluidic pharmaceutical compound, such asa chemotherapy compound. The pharmacy preparation system 1 assistspharmacists or non-pharmacist technicians in preparing a syringe orintravenous (IV) bag with one or more prescribed pharmaceuticalcompounds. The pharmacy preparation system 1 is operatively connected toa computing device 4 that includes a user interface 3 having a display 5and a user input device 7, such as a keyboard, mouse, etc. Optionally,the display 5 of the user interface 3 may be implemented as a small LEDprojector provided on a portion of the pharmacy preparation system 1 forprojecting the displayed information on a back wall of a laminar flowhood 25, thereby removing the need of a monitor for the display 5 asshown in FIG. 2 . A scale 9 having a scale output interface 11 may beoperatively connected to the user interface 3. The scale 9 may beimplemented as any suitable device for detecting a change in mass orweight when an object is placed thereon. Accordingly, the scale 9 maysimply be configured as a device that sends a signal when the mass orweight of an object is greater or less than a predetermined threshold ora high-precision scale that provides an accurate reading of the weightof an object placed thereon.

In one embodiment, a barcode scanner 13 may be operatively connected toat least one of the user interface 3 and the scale 9, such that thebarcode scanner 13 may scan a medication vial having a barcode that isplaced onto a portion of the scale 9. In another embodiment, an imagecapture device 15 may be operatively connected to at least one of theuser interface 3 and the scale 9, such that the image capture device 15may take a picture of an item, such as a medication vial, IV bag, orsyringe placed onto a portion of the scale 9. In one embodiment, theimage capture device 15 may capture a plurality of still images orrunning video of items placed onto a portion of the scale 9 throughoutthe medication compounding process for documentation and/or subsequentreview of the medication compounding process.

In still another embodiment, at least one of the barcode scanner 13 andthe image capture device 15 may be at least partially enclosed within anenclosure housing 17. In certain configurations, the housing 17 mayfully enclose the barcode scanner 13 and the image capture device 15.Optionally, the housing 17 may include only one of the barcode scanner13 and the image capture device 15.

The housing 17 may be positioned above a portion of the scale 9, such assupported by a supporting arm 19. As shown in FIG. 2 , the pharmacypreparation system 1 may be positioned within a laminar flow hood 25having an inlet air source 23 and an outlet air port 27 for creating alaminar flow of air within an interior 29 of the laminar flow hood 25.An exterior surface 21 of the housing 17 may have a streamlined shapeand/or profile which is optimized to reduce disruption of the flow ofair within the laminar flow hood 25.

This aerodynamically streamlined housing 17 as shown in FIG. 3 isdesigned in such a way to minimize the airflow disturbance that iscreated by having a device in a laminar airflow stream. Thisconfiguration allows the device to be placed in the upstream vicinity ofa scale and still have an acceptable gravimetric accuracy (i.e. +/−0.05g) and stabilization time (i.e. no more than 2 additional seconds) forverifying medication preparation purposes.

The smaller and/or more streamlined housing 17 results in a smaller flowdisturbance and therefore a higher likelihood of meeting accuracy andstability requirements. The streamlined housing 17 has a form thatminimizes flow disruption and drag, allowing for stable and accurategravimetric readings that are required for medication preparationpurposes. In addition, housing 17 allows for required gravimetric scaleaccuracy and stability, while placing the input devices (i.e., imagecapture device 15 and barcode scanner 13) in the upstream airflowvicinity relative to the scale 9. Placing these objects within the scale9 vicinity is typically the ideal area for a number of reasons. Asecondary advantage to the streamlined housing 17 is to provide andmaintain a clean working environment for the sterile preparation ofmedications. In use, the purpose of the air stream in a flow hood is tocreate a clean zone for sanitary reasons. A turbulent zone created byobjects near, or upstream of the airflow, may result in a potentialcontamination hazard during medication preparation. As a result, havingan aerodynamically shaped housing for input devices minimizes the amountof laminar airflow disruption and decreases the chances of any type ofcontamination.

With continued reference to FIG. 3 , the scale 9 may include a platen31, such as a portion of the weighing surface of the scale 9, which mayprovide a visual indication, such as a cross recess 35, to thetechnician of a center of an image to be captured by the image capturedevice 15. This allows a technician to properly position drugcompounding related medications 37 and related supplies within the fieldof view of the image capture device 15, such as the image capture deviceenclosed within the housing 17 positioned above the platen 31 of thescale 9. An upper surface 41 of the platen 31 may define a plurality ofrecessed grooves 39 and/or protrusions extending from a surface of theplaten 31 to frictionally restrain drug compounding related medications37 and related supplies on the upper surface 41 of the platen 31. Inanother configuration, the upper surface 41 of the platen 31 may includea tackifier or other frictionally enhancing surface to similarlyrestrain drug compounding related medications 37 and related supplies onthe upper surface 41 of the platen 31. The arrangement of grooves 39and/or protrusions may easily indicate to a user the center of theplaten 31 which may be arranged to coincide with the center of the fieldof view of the image capture device 15.

The plurality of recessed grooves 39 and/or protrusions extending from asurface of the platen 31 may be configured to restrain any liquidmaterial that is accidentally spilled on the upper surface 41 of theplaten 31 during a drug compounding procedure. The plurality of recessedgrooves 39 may define a receiving well 47 which serves to collect andrestrain accidentally spilled material in a confined area within theplaten 31 until proper disposal techniques may be employed. The surfaceof the platen 31 may be coated with a durable composition that resistsdegradation caused by exposure to caustic agents, such as chemotherapycompounds and drugs, as well as cleaning agents, such as bleach,isopropyl alcohol, and the like. In certain configurations, the durablecomposition may be an epoxy or epoxy-based paint or coating.

With reference to FIGS. 4, 14A, and 14B, in operation, thepharmacist/technician is prompted through a series of display screensprovided on the display 5 of the user interface 3 as shown in one ormore of FIGS. 5A-5D, 6A-6D, 7A-7B, 8A-8D, 9A-9D, 10A-10C, 11A-11D,12A-12C, and 13A-13C to take the following steps to prepare thepharmaceutical compound. FIG. 4 provides a flow chart of a first phaseof the preparation in which an active ingredient is reconstituted.First, the operator scans a first barcode with the barcode scanner 13 ona medication container including a drug to be reconstituted to preparethe prescribed pharmaceutical compound (block 301) as shown in FIG. 5C.Then, the medication container is placed on the scale 9 (block 302). Arepresentation of this step is displayed on display 5 of user interface3 as shown in FIG. 6A. Once the weight stabilizes, the system verifiesthat the measured weight is meeting the weight target plus/minus apredetermined tolerance. In addition, the image capture device 15 takesan image of the medication container and displays it to the user on thedisplay 5 of the user interface 3 (block 304) as shown in FIG. 6B. Theuser then removes the medication container and the image is saved to thedata record of the drug preparation (block 306).

Next, the technician scans a second barcode of a fluid container offluid that is to be mixed with the drug to be reconstituted (block 308)as shown in FIG. 6C. The fluid container is then placed on the scale 9(block 310) and, once the weight stabilizes, the image capture device 15takes an image of the fluid container and displays it to the user on thedisplay 5 of the user interface 3 (block 312) as shown in FIG. 6D. Theuser then removes the fluid container and the image is saved to the datarecord of the drug preparation (block 314).

Thereafter, the user mixes the drug to be reconstituted with the fluidin the fluid container by injecting the fluid from the fluid containerinto the medication container (block 316) as shown in FIG. 7A. Themedication container is then returned to the scale 9 and the weight ofthe medication container is verified (block 318) as shown in FIG. 7B.Once the weight is stabilized and verified (block 320), the imagecapture device 15 automatically takes an image of the medicationcontainer based on a signal received from the scale and displays theimage on the display 5 of the user interface 3 (block 322). If thetechnician decides the image was not meeting certain requirements, thereis the option to request a new or additional image (block 324).Requesting another picture will automatically switch the image capturedevice 15 into a “live video mode” displayed at the user interface 3(block 326). The technician can now move the medication container on thescale 9 to a preferred position and trigger the image capture throughthe user interface 3 (block 328). As before, the captured image will beshown at the user interface 3 and by removing the item from the scale 9,the technician accepts the image and the system automatically moves tothe next compounding step (block 330).

Once the drug preparation is complete, the system prints a barcode labelfor placement on the reconstituted drug preparation.

With reference to FIGS. 14A and 14B, a second phase of the preparationof the pharmaceutical compound using the pharmacy preparation module 300will be described. First, the operator scans a barcode with the barcodescanner 13 on the reconstituted drug preparation (block 332) as shown inFIG. 8A. Then, the reconstituted drug preparation is placed on the scale9 (block 334) and an empty syringe is added to the scale 9 (block 336)as shown in FIG. 8C. Once the weight stabilizes, the system verifiesthat the measured weight is meeting the weight target plus/minus apredetermined tolerance. In addition, the image capture device 15 takesan image of the medication container and displays it to the user on thedisplay 5 of the user interface 3 (block 338) as shown in FIG. 8D. Theuser then removes the reconstituted drug preparation and the emptysyringe and the image is saved to the data record of the drugpreparation (block 340).

Next, the technician is instructed to withdraw a predetermined amountfrom the reconstituted drug preparation with the syringe (block 342) asshown in FIG. 9A and places the syringe back on the scale 9 (block 344).The weight is then verified (block 346) and an image is captured (block348) as shown in FIG. 9B. If the weight is determined to be too low asshown in the flow chart of FIGS. 14A and 14B, the technician isinstructed to remove the syringe (block 350 and FIG. 9C) and withdraw anadditional amount of the reconstituted drug preparation (block 352 andFIG. 9D).

Once the additional amount of the reconstituted drug preparation iswithdrawn into the syringe, the syringe is placed back on the scale 9(block 354) as shown in FIG. 10A. The weight is then verified (block356) and an image is captured (block 358) as shown in FIG. 10B. Thesyringe is then removed from the scale (block 360).

The technician then scans a barcode of a fluid container having a salinesolution therein, such as an IV bag (block 362). The fluid container isthen placed on the scale 9 (block 364) and, once the weight stabilizes,the image capture device 15 takes an image of the fluid container anddisplays it to the user on the display 5 of the user interface 3 (block366). If the technician decides the image was not meeting certainrequirements, there is the option to request a new or additional image(block 368). Requesting another picture will automatically switch thecamera into a “live video mode” displayed at the user interface 3 (block370). The technician can now move the medication container on the scale9 to a preferred position and trigger the image capture through the userinterface 3 (block 372). As before, the captured image will be shown atthe user interface 3 and by removing the item from the scale 9, thetechnician accepts the image (block 374) and the system automaticallyawaits authorization from a pharmacist to precede (block 376). Thescreen shots in FIGS. 11A-11C illustrate this procedure.

Once pharmacist authorization has been provided (block 378), the userinjects the contents of the syringe into the fluid container (block 380)as shown in FIG. 12A. The medication container is then returned to thescale 9 and the weight of the medication container is verified (block382). Once the weight is stabilized and verified (block 384) as shown inFIG. 12B, the image capture device 15 automatically takes an image ofthe medication container based on a signal received from the scale anddisplays the image on the display 5 of the user interface 3 (block 386)as shown in FIG. 12C. As before, the captured image will be shown at theuser interface 3 and by removing the item from the scale 9, thetechnician accepts the image (block 388). Once the drug preparation iscomplete, the system prints a barcode label for placement on thecompleted drug preparation that includes encoded informationrepresenting the name of the pharmaceutical and patient information.

The pharmacy preparation module 300 also includes software instructionsthat cause the processor of the computing device 4 to perform thefollowing actions during the drug preparation: (i) retrieve theprescription information data input by the physician in the CPOE module100 from the intra-hospital network; (ii) verify that the scannedbarcode corresponds with the prescription information; (iii) determineif the weight of the syringe and/or IV bag is within a predeterminedthreshold accuracy level for the amount of the pharmaceutical to beadministered; (iv) determine what adjustments must be made if the weightis not accurate; and (v) transmit data relating to the weight of thesyringe and/or IV bag back to the intra-hospital network.

D. Pharmacy Final Verification Module

Subsequent to preparing the prescribed pharmaceutical, the pharmacyfinal verification module 400 allows the pharmacist to review the dataand/or documentation created by the pharmacy preparation module 300including the images taken by the image capture device 15 and eitherapprove or disapprove the preparation for the release to the patient. Asdescribed hereinabove, the pharmacist final verification module 400 maybe implemented on the same computing device as the pharmacy preparationmodule 300. Alternatively, the pharmacist final verification module 400may be implemented on a computing device that is remote from thecomputing device of the pharmacy preparation module 300. Such a remoteconfiguration is illustrated schematically in FIG. 15 . With referenceto FIG. 15 , the pharmacist final verification module 400 includes asystem 401 having a processor 402 configured to receive information fromthe pharmacy preparation module 300 regarding the preparation of thepharmaceutical compound. The information comprises at least one image ofat least one step of the preparation of the pharmaceutical compound andgravimetric measurement information provided by the scale 9 during atleast one step of the preparation of the pharmaceutical compound. Thesystem 401 also includes a user interface 403 operatively connected tothe processor 402 and configured to display, based on instructions fromthe processor 402, the at least one image of the at least one step ofthe preparation of the pharmaceutical compound and an indication ofwhether a concentration of the pharmaceutical compound is within anacceptable tolerance range based on the gravimetric measurementinformation.

An exemplary screen shot provided at the pharmacy final verificationmodule 400 is provided in FIG. 16 . On this exemplary screen, thecaptured images are shown with the corresponding compoundinginstructions and an indication of whether the concentration of a drug isinside or outside of the acceptable tolerance range as determined by themathematical methodology. Accordingly, the pharmacy final verificationmodule 400 provides visual information (i.e., the pictures of each stepof the preparation) overlaid with quantitative measurements collectedwith the scale and verified by the mathematical methodology to adhere topredefined acceptance criteria.

As illustrated in FIGS. 16 and 17 , the pharmacy final verificationmodule 400 includes a review window 420 having a first portion 422 thatdisplays a selected image 424 of a particular drug preparation step, asecond portion 426 that displays thumbnail images of each of the drugpreparation steps, and a third portion 428 that displays the compoundinginstructions for the particular drug preparation step along with theresult of the quantitative measurement provided by the scale, and anindication provided by the mathematical methodology that theconcentration of a drug is either inside or outside of the acceptabletolerance. In addition, an icon 430 may be associated with the thumbnailof the particular drug preparation step to provide an indication to thepharmacist that the tolerance requirements of the particular drugpreparation step were met. For instance, a green check mark may beprovided if the tolerance requirements were met or a red exclamationpoint may be provided if the tolerance requirements were not met. Thereview window 420 may also include a fourth portion 432 that displaysicons 434 allowing the pharmacist to either confirm or reject the drugpreparation.

With continued reference to FIGS. 16 and 17 , the mouse pointer washovering over the fifth thumbnail from the left in the second portion426 of the review window 420. For this particular thumbnail, theenlarged picture is shown above the thumbnail row in the first portion422 of the review window 420 and below the thumbnails, the correspondingcompounding instructions 435 along with the result of the quantitativemeasurement 436 and methodology check 438 (see also the exemplaryscreenshot provided in FIG. 2 ) are shown in the third portion 428 ofthe review window 420. The third portion 428 may also include otherstatistical information regarding the drug preparation such as, but notlimited to, how often compounding steps had to be repeated to meettolerance targets or if particular compounding steps took more time thanusual compared to other cases.

Additionally, the icon 430 in the thumbnail indicates if the tolerancerequirements of the particular compounding step were met, giving thepharmacist a quick guidance to where in the compounding procedureproblems occurred. A gray box (not shown) around multiple thumbnailsprovides an indication to the pharmacist that the image representingthis compounding step was retaken.

The overlay of a captured image with verification information generatedby a mathematical methodology from gravimetric data allows thepharmacist to quickly review very different types of information. Thevisual information content of the image allows the pharmacist to checkvery apparent information such as, but not limited to, the drug color,the syringe type, or whether the system was used improperly (e.g., theuser used an additional object to generate the necessary weight to passthe tolerance requirements of the methodology). The icon 430 in thethumbnail representing the methodology check outcome is binaryinformation telling the pharmacist that the amount of drug was eitherinside or outside of the tolerance requirements for the particularcompounding step. An accumulation of icons 430 on thumbnails in the formof red exclamation marks provides a quick indication to the pharmacistthat the technician needed several iterations to meet tolerancerequirements and may trigger additional scrutiny when reviewing such adrug preparation.

E. Bedside Module

Prior to administering the prescribed pharmaceutical to a patient, thebedside module 500 allows for a final verification. A barcode scannerlocated proximate to a patient is used by a nurse or other technician toscan the barcode label on the syringe and/or IV bag. The barcode scanneris in communication with a computer, which verifies the informationencoded on the second barcode with patient information and/orprescription information retrieved from the intra-hospital network.

While specific embodiments of the invention have been described indetail, it will be appreciated by those skilled in the art that variousmodifications and alternatives to those details could be developed inlight of the overall teachings of the disclosure. Accordingly, theparticular arrangements disclosed are meant to be illustrative only andnot limiting as to the scope of invention which is to be given the fullbreadth of the claims appended and any and all equivalents thereof.

The invention claimed is:
 1. A system for preparing a pharmaceuticalcompound, comprising: a computing device comprising a user interfaceproviding an operator with instructions for preparing the pharmaceuticalcompound and at least one processor operatively connected to the userinterface; a scale operatively connected to the at least one processor;and an enclosure comprising an image capture device having a field ofview positioned to capture an image of an object positioned on the scaleduring the preparation of the pharmaceutical compound, the image capturedevice operatively connected to the at least one processor, wherein thescale transmits a signal to the at least one processor to verify acorrect amount of at least one component of the pharmaceutical compoundbased on a weight of the at least one component, and wherein the imagecapture device captures an image of the object positioned on the scalewhen the at least one processor verifies the correct amount of the atleast one component.
 2. The system of claim 1, wherein the enclosure ispositioned above the scale.
 3. The system of claim 1, wherein theenclosure further comprises a barcode scanner.
 4. The system of claim 3,wherein the barcode scanner is angled with respect to the scale.
 5. Thesystem of claim 3, wherein the barcode scanner has a sensor that isoffset with respect to the scale.
 6. The system of claim 1, wherein theenclosure has a streamlined shape to minimize flow disturbance within aflow hood.
 7. A system for preparing a pharmaceutical compoundcomprising: a computing device comprising a user interface providing anoperator with instructions for preparing the pharmaceutical compound andat least one processor operatively connected to the user interface; ascale operatively connected to the at least one processor; and an imagecapture device operatively connected to the at least one processor andthe scale and positioned to capture an image of at least one of acomponent used in preparing the pharmaceutical compound and thepharmaceutical compound, wherein the scale transmits a signal to the atleast one processor indicating that a weight detected thereby haschanged when the at least one component is placed thereon and, based onthe signal, the at least one processor triggers the image capture deviceto capture the image of the at least one component.
 8. The system ofclaim 7, wherein the image of the at least one component is displayed onthe user interface for review by the operator.
 9. The system of claim 8,wherein a removal of the at least one component from the scale causesthe at least one processor to accept the image, associate the image witha data record, and provide instruction on the user interface to allowthe operator to move to a next step of the instructions for preparingthe pharmaceutical compound.
 10. The system of claim 9, wherein the datarecord and images are transmitted to a pharmacist workstation forverification.
 11. The system of claim 8, wherein, if the image is deemedto be unacceptable by the operator, the user interface is configured toprovide the operator with the capability to recapture the image.
 12. Thesystem of claim 7, wherein the image is saved to a database when theweight of the at least one component or the pharmaceutical compound onthe scale has been verified by the at least one processor.
 13. Thesystem of claim 12, wherein the scanner is configured to scan a barcodeprovided on the at least one component and provide the at least oneprocessor with information regarding the at least one component.
 14. Asystem for preparing a pharmaceutical compound comprising: a computingdevice comprising a user interface, the user interface configured todisplay: instructions for preparing the pharmaceutical compound and atleast one processor operatively connected to the user interface; and alisting of equipment and/or components used to prepare thepharmaceutical compound; a scale operatively connected to the at leastone processor; and an image capture device operatively connected to theat least one processor and the scale and positioned to capture an imageof at least one of a component used in preparing the pharmaceuticalcompound and the pharmaceutical compound.
 15. The system of claim 14,wherein the image of the at least one component is displayed on the userinterface for review by an operator.
 16. The system of claim 15, whereina removal of the at least one component from the scale causes the atleast one processor to accept the image, associate the image with a datarecord, and provide instructions on the user interface to allow theoperator to move to a next step of the instructions for preparing thepharmaceutical compound.
 17. The system of claim 16, wherein the datarecord and the images are provided to a pharmacist for verification. 18.The system of claim 14, further comprising a scanner operatively coupledto the user interface.
 19. The system of claim 18, wherein the scanneris configured to scan a barcode provided on the at least one componentand provide the at least one processor with information regarding the atleast one component.
 20. The system of claim 19, wherein the scanner isarranged in a housing positioned above the scale.
 21. The system ofclaim 20, wherein the housing has a streamlined shape to minimize flowwhen the system is arranged within a flow hood.